There are two relatively standard methods of hospital management of acute schizophrenic episodes. One relies upon psychotropic drug treatment alone and the other combines drug treatment with ECT. In the very few studies in which such treatment has been randomly or arbitrarily assigned to comparable groups, there appears to be some advantage in the ECT-drug combination. However systematic studies of large numbers of patients with individualization of dosage of drugs and length of the seris of ECT have not been accomplished. Such a project is proposed in this application with additional evaluations of groups of patients treated with ECT and placebo and placebo alone. The latter groups are included to provide for a modified double blind design as well as to highlight any differences between the two major treatment groups. Outcome measures to be evaluated include rapidity and amount of clinical improvement as well as duration of hospital stay, cost of treatment and length of time that patients can be maintained on the initially assigned treatment. One hundred and forty-five patients will be studied over a three-year period.